Provider Demographics
NPI:1225635642
Name:PRISTINE HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:PRISTINE HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:IVOKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-864-6065
Mailing Address - Street 1:9087 ARROW RTE STE 248
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4488
Mailing Address - Country:US
Mailing Address - Phone:909-481-3463
Mailing Address - Fax:
Practice Address - Street 1:9087 ARROW RTE STE 248
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4488
Practice Address - Country:US
Practice Address - Phone:909-481-3463
Practice Address - Fax:909-481-3473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health